[Congressional Record (Bound Edition), Volume 150 (2004), Part 1]
[Senate]
[Pages 368-369]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                DIABETES

 Mr. JOHNSON. Mr. President, as we commence the second session 
of the 108th Congress, I want to take this opportunity to bring 
attention to a serious health problem that our Nation faces everyday. 
This health care dilemma encompasses all ages, genders, and races in 
our Nation. I am referring to diabetes, which impacts 18.2 million 
people in the United States, or 6.3 percent of the population. As we 
embark on this session, we need to reconfirm our commitment to 
addressing a key objective of many in Congress to fight this chronic 
health problem which threatens the lives of millions.
  The American Diabetes Association, as well as the Center for Disease 
Control and Prevention or CDC, has stated that of the 18.2 million 
Americans living with this disease, only an estimated 13 million have 
been diagnosed, therefore leaving 5.2 million people, or nearly one-
third, completely unaware that they have the disease. There are three 
major types of diabetes; Type 1, Type 2, and gestational diabetes. Type 
1 diabetes results in the body's failure to produce insulin. The ADA 
believes that 5-10 percent of Americans who are diagnosed with diabetes 
have Type 1. Type 2 diabetes results from insulin resistance, combined 
with relative insulin deficiency. Approximately 90-95 percent, 17 
million, of Americans who are diagnosed with diabetes have this type of 
diabetes. Gestational diabetes affects about 4 percent of all pregnant 
women--about 135,000 cases in the United States each year. About 
110,814 Native Americans and Alaska Natives, or 14.9 percent of the 
population, receiving care from Indian Health Services, IHS, have 
diabetes.
  Diabetes is associated with many other serious chronic health 
conditions. About 65 percent of deaths among people with this illness 
are due to heart disease and stroke. Heart disease is the leading cause 
of diabetes-related deaths, while the risk for stroke is 2 to 4 times 
higher among people with this illness. About 73 percent of adults with 
diabetes have high blood pressure or use prescription medications for 
hypertension. Diabetes is the leading cause of new cases of blindness 
among adults aged 20-74 years, with diabetic retinopathy causing 12,000 
to 24,000 new cases of blindness each year. Diabetes is the leading 
cause of end-stage renal disease, accounting for 44 percent of new 
cases. Sixty to 70 percent of people with diabetes have mild to severe 
forms of nervous system damage. The results of such damage include 
impaired sensation or pain in the feet or hands, slowed digestion of 
food in the stomach, carpal tunnel syndrome, and other nerve problems. 
In addition, this contributes to more than 60 percent of lower-limb 
amputations each year. Gum disease is more common among people with 
diabetes, thus placing young diabetics at twice the risk of those 
without this condition. Poorly controlled diabetes before conception 
and during the first trimester of pregnancy can cause major birth 
defects in 5 percent to 10 percent of pregnancies. Poorly controlled 
diabetes during the second and third trimesters of pregnancy can result 
in excessively large babies, posing a risk to the mother and the child. 
Uncontrolled diabetes often leads to biochemical imbalances that can 
cause acute life-threatening events, such as diabetic ketoacidosis and 
hyperosmolar coma. People with diabetes are more susceptible to many 
other illnesses, and once they acquire these illnesses, often have 
worse prognoses, such as being more likely to die with pneumonia or 
influenza than people who do not have diabetes.
  In 2002, 47,555 or 6.3 percent of South Dakotans, were diagnosed with 
diabetes. And when applying the national estimate that nearly one-third 
of all diabetes cases go undiagnosed, this would add an additional 
estimated 15,693 cases. This means that the most recent number of South 
Dakotans with diabetes could be an estimated 71,000 people. Also, 
important to South Dakota are estimates by the American Diabetes 
Association that Native Americans have a higher rate of diabetes, which 
makes this group 2.2 times more likely to have diagnosed diabetes as 
non-Hispanic whites of similar age.
  A report showed that the indirect costs associated with diabetes were 
$40 billion in the United States in 2002, while direct medical costs 
were approximately $92 billion, therefore

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bringing the overall costs in our country to $132 billion. It is 
estimated that each year there are 1.3 million new cases of diabetes 
diagnosed in people aged 20 and older. Increased emphasis on prevention 
will help reduce the incidence of new cases and be a step in the right 
direction to reduce the social, economic and human costs associated 
with diabetes.
  Congress has the ability to enhance Federal programs and increase 
funding to combat this debilitating illness. I was pleased to see the 
bipartisan dedication to doubling the funding of the National 
Institutes of Health, NIH, over a 5-year period, which was completed in 
2003. This initiative alone has helped to expand current research, 
which therefore improves the path toward finding treatment and cures of 
all diseases, including that of diabetes. As a member of the Senate 
Appropriations Committee, I was pleased to work with my colleagues on 
both sides of the aisle to request $1.6 billion for the National 
Institute of Diabetes and Kidney Diseases for fiscal year 2004. In 
addition to NIH, we must continue to fight to secure increased funding 
for the Centers for Disease Control and Prevention, CDC. The CDC 
provides invaluable research on chronic diseases such as diabetes, and 
helps fund important state program such as the South Dakota Diabetes 
Prevention and Control Program, DPCP.
  I encourage both Congress and the President to continue to build on 
existing efforts to address diabetes through increased funding for NIH, 
for the Institute of Diabetes and Kidney Diseases, and for the CDC in 
the upcoming year. I believe that we can achieve this goal in 
bipartisan fashion and provide greater assistance to the many Americans 
in all parts of our Nation that live with this chronic illness.

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